For anyone who is paying less than $100 copay monthly for Enbrel..... could I please ask you if your insurance plan is:
a) Small Group
b) Large Group or
c) Individual Plan
I'm trying to sort this out with our insurance administrator, and she said that she had not heard of anyone paying $30 or $50 for Enbrel, and suggested that I ask you what kind of plan you were on. Thanks for your help!
Sue

When my daughter was on Enbrel we paid $9.00 every 4 weeks. She got 2 25mg injections per week.
Ours is a large group plan.

Suzanne,
I know you asked for those with LESS than $100.00, but I thought I'd chime in as I have bc/bs of California ( I already said in an earlier post that I pay $ 100.00).
I have a PPO with a large group plan. My card reads plan 040: Wellpoint Pharmacy-medical.
My co-pay would be less if I mailed ordered the scrip, but living in Florida and never knowing exactly when I'll be home, I opt for the more expensive system of ordering from Walgreens on a monthly basis.
Hope some of this may be of use to you.

Hi there, I am taking 50mg twice a week. I am paying a $40 copay through United Healthcare. My company has about 300 employees, I'm not sure what group size that places us in. I had to fight with them at first to get approved but the $40 is pretty reasonable I guess. I pay $25 for soriatane. I am finally getting my moneys worth from the insurance company. Good Luck...J5

I was on Enbrel for 6 months with a group plan paying $7 a month.
My current insurance company has a copay of $75 / month.

When I was on embrel I had a $15.00 copay. now that im on Humira i have no copay. My insurance is E.M.I. Abbot is paying my $15.00 copay.
Later
Dennis

Suzanne,
I am on my husband's CIGNA (PPO) plan through his (large) company. I do 2 25 mg. shots a week for PA (so that's 8 shots per month) and my monthly co-pay is $20.00. If I did the mail order route for a 3 month supply it would be a little less. I also take Zyrtec for seasonal allergies (30 pills per month in spring and summer). For THAT I have a co-pay of $40.00. Makes no sense!
Nancy

Large company here.... Also, moved over to a start-up (less than 700) and received the same $40 co-pay as with my internationally large company.

Thanks everyone!!! Please if anyone else has something to add, please let me know.......... the more info I have, the better!! :)

My BCBS of Cal. group plan had a $20 copay regardless of if I did 100mg a week or 50 mg a week
Most plans have a fixed copay X dollars for a months supply or in some cases a 3 month supply if you use their mail pharm.
I have seen a few plans that pay a percent of the Rx, i.e. they pay 80%, you pay 20%.
It seems like HMOs do the fix copay, and true insurance (rare these days) do the %
Dennis

Large group. I had blue cross blue shield of Minnesota. My co-pay for enbrel was $75. for a 3 month supply if I went through the mail order pharmacy. If I had it filled at a local pharmacy it would have been $50. a month. Seeing how it was half the price by getting through the mail, that it what I did.
Polly

I have Blue Cross/Blue Shield of Texas and I pay $30 for 8 50MG/ML shots. I'm on a PPO plan. There are about 100 employees in my company. If you would like anymore info, feel free to ask.
Charley

I have Aetna PPO through my employer (120 employees). My copay is $35/month. It would be $70/3 months if I did mail order.

Hi Sue, I pay $25.00 per month. To answer your question, insurance plans are determined by your employer regardless of the size. Your employer determines what benefits are covered and negotiates what the co-pay is for any service.

I have Aetna PPO small group and I use their mail order and I pay $20/month ($60 at once for a three month supply) of 50mg shots of enbrel that I use twice a week. If I got it through a pharmacy, I would pay $30/month.

Hi,just thought i'd toss this into the mix. When I had advance pcs for rx coverage (through a large retail pharmacy chain) I was paying either 100/month,200/3 months,or 10% whichever was less. needless to say,I was paying 200/3 month supply. We then switched our rx coverage to Aetna. Now,I still work in that same retail pharmacy,but,Aetna won't let me get my Enbrel there. I was a little ticked off about that,until the woman at the mail order pharmacy told me my co pay would be 0. Yes kids,0. Let me tell you I was on cloud 9 all day after hearing that!
Now,working in a pharmacy,I see all kinds of co pays. They seem to range from 200/month (anthem wich includes most blue cross plans) to as low as 15/month ( a cigna plan). Most of the plans the people around here have won't let them do a 3 month supply at a retail pharmacy,they make people use mailorder for that. I would look into the co pay assistance plans out there. Even if you have a good income,they may help with some of it. the other thing is,with a lot of plans,once you hit a certain out of pocket amount,(i think you said yours was around 1400/yr?) then your rx's really are free or greatly reduced. i know it's a lot of money (the 700+ copay),I wouldn't be able to pay it. But if you can,then in 2 rx's you will be at that cut off amount. Just make sure you know when you plan year starts. For example,mine is July. you don't want to put out that 1400 and then in a month find out your plan year started again and now you have to pay again right away. Hope you find a way to get better co pays and I hope youhave great sucess with Enbrel. It has worked wonders for me!

Well, we only have 14 employees so I assume it's small. We have GHI by the way.

I pay $30/month. I have Blue Cross of MN and I work for a small law firm (about 35 people, maybe). We have had a few people battling cancer and other illnesses in the past couple years and that might be why we have a "better" but very expensive plan.

I am the supervisor of benefits and compensation for our organization. Our plan is self-funded, not an insured product. We cover about 2,000 employees.
Last year, we covered enbrel with a co-pay ($25.00). However, this year we moved the biologics under the major medical. Now, the user must meet their deductible (either $100 or $600, depending on the plan) and then pay 10%. Once they reach their max out of pocket for the year, the plan pays at 100%.
I received some complaints about this change, but since I am on Remicade, I was able to explain the change with a bit more compassion. The biologics are expensive - I know. In today's consumer-driven healthcare movement, though, we can expect to have to pay more (higher share) for these meds as time goes on. Plans can't continue to fund these high cost treatments without a little more responsibility from the consumer.
I'm caught in the middle. As a biologic user, I want as much paid by the insurance as possible. As a plan administrator, I want individuals to begin to be responsible for more.....
I wish there was an easy answer.

When I was on enbrel I paid $30/month. I am on a large group plan (2000 employees) and we use Humana PPO.

I am with a large company. I pay $15 co-pay.
Take care,
Diane

I have a large company, Kaiser, and pay $15 a month; my previous insurance was Blue Shield and I paid $25 a month. This benefit is a major blessing and my heart goes out to those who pay hundreds.

I have BCBS of Mi and pay a $20 for 3 mos co pay if I receive the RX by mail or a $20 per mo if purchased at a local pharmacy. It is through a med size company.

I had to pass on Enbrel even though my insurance company approved it. We have an 80% - 20% plan and 20% of $2500 per month is way out of my league. We are a self insured company with over 10K employees on the plan; which is actually pretty decent for the hospitality industry-probably better than most. I was a little freaked out going to a biologic with all the side effects I had just suffered with Soriatane after only 1 month. The Co-Pay just helped me say "no" when I really wanted to anyway basically. I'm back to topicals again and have my good days and bad ones. I guess we all know those days! Good Luck to you....